Development/Evaluation of Interactive Cognitive Training

DESCRIPTION (provided by applicant): Americans are living longer and driving more. Furthermore, older adults are more prone to crashes than any other age group except inexperienced drivers. However, a recent and growing body of literature has demonstrated that older drivers at risk for crashing can be identified with a brief screening battery and once identified, cognitive skills important for safe driving can be improved. In particular, Speed of Processing, as measured by the UFOV test, is highly predictive of future crash involvement. In addition, improvements in visual processing speed have been shown to directly improve on-the-road driving performance, thereby enhancing and preserving mobility into later life. Traditionally, such improvements in visual processing speed have been achieved through training on a set of computer exercises with the guidance of a certified trainer. The purpose of this Fast Track application is to develop and validate an enhanced self-administered interactive variation of these validated training techniques. Therefore, the specific aims of this Fast Track application are: Phase I: 1) Develop an enhanced self-administered interactive version of Speed of Processing training for use by individuals who demonstrate elevated crash risk during a Fitness to Drive assessment currently being used by State Farm Insurance Company in Alabama. 2) Evaluate the acceptability and effectiveness of the this training software through an interactive focus group process to achieve acceptability, and a laboratory based test to demonstrate effectiveness of the new software relative to the trainer guided method. 3). Establish the mechanisms for a large-scale evaluation of the training product. Phase II: Conduct a state-wide evaluation of the training product in Alabama. To this end, we will continue to work with State Farm to assist us in evaluating the new training product on a large sample (minimum N=1000) of adults aged 75 and older with high-risk status. Specifically, we will 1) examine the proportion of individuals achieving low-risk status post-training, and 2) examine the effectiveness of the training in lowering crash risk and insurance claims, relative to a) individuals who are low-risk at baseline, b) individuals who are high risk at baseline but decline to undergo training, as well as by c) comparing crash occurrence and insurance claims during retrospective and post-training intervals of 1 to 2 years. Relevance: The public health benefits of this project are clear. By developing a method for older adults to improve the cognitive skills important for safe driving without the help of a trainer, the cost of implementing such training on a broad scale can be reduced, availability of training increased and long term safety, mobility, and quality of life improved.